Cost effectiveness of desirudin compared with a low molecular weight heparin in the prevention of deep vein thrombosis after total hip replacement surgery
Research article published in PharmacoEconomics (2001)
Abstract
OBJECTIVES: This prospective pharmacoeconomic study analyses and discusses the cost effectiveness (expressed as cost per life-year gained) of desirudin in comparison with a low molecular weight heparin (LMWH), enoxaparin, as prophylaxis against deep vein thrombosis (DVT) in total hip replacement. METHODS: The cost effectiveness was analysed on the basis of results from a clinical trial that compared the recombinant hirudin, desirudin, with the LMWH, enoxaparin. The trial results regarding the incidence of DVT are included together with epidemiological data in a decision tree, simulating long term cost effectiveness of patients undergoing elective hip replacement. The model includes Markov processes simulating patients up to the age of 85 years, including the costs of DVT-related long term complications. RESULTS: The average total thrombosis-related cost per patient under prophylactic therapy with enoxaparin is 7,022 Swedish kronor (SEK) compared with SEK7,497 when using desirudin (1998 values). The total costs with desirudin are 7% higher. Prophylaxis with desirudin in those patients undergoing elective hip replacement surgery adds, on average, 7 days of life per patient when compared with treatment using enoxaparin. This is equivalent to 1.91 additional years of life per 100 patients treated. The incremental cost-effectiveness ratio of prophylaxis with desirudin in patients undergoing elective hip replacement surgery is SEK24,864 per life-year gained in comparison with enoxaparin. CONCLUSION: The present study demonstrates that prophylactic therapy with desirudin is a cost-effective approach for the prevention of DVT in patients undergoing total hip replacement.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Cost effectiveness of desirudin compared with a low molecular weight heparin in the prevention of deep vein thrombosis after total hip replacement surgery.
Why This Matters for Hirudotherapy
This pharmacoeconomic study evaluates the cost-effectiveness of desirudin, identified in the abstract as a recombinant hirudin, compared with the low-molecular-weight heparin enoxaparin for preventing deep vein thrombosis after total hip replacement surgery. Using a decision tree model with Markov processes simulating patients up to age 85, the analysis found that while total costs with desirudin were 7% higher, it added an average of 7 days of life per patient, yielding an incremental cost-effectiveness ratio of SEK 24,864 per life-year gained. The abstract does not mention leeches, leech saliva, or any leech secretome, so no connection to hirudotherapy is established beyond the pharmaceutical term 'recombinant hirudin.' The study's relevance is limited to the economics of a specific drug in surgical thromboprophylaxis.
Citation
Cost effectiveness of desirudin compared with a low molecular weight heparin in the prevention of deep vein thrombosis after total hip replacement surgery
Levin LA et al. · PharmacoEconomics, 2001
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